Provider Demographics
NPI:1053198937
Name:GIANNETTA, ANGELA (LSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GIANNETTA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 CLARENDON AVE APT 42
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1938
Mailing Address - Country:US
Mailing Address - Phone:267-895-5153
Mailing Address - Fax:
Practice Address - Street 1:3750 CLARENDON AVE APT 42
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1938
Practice Address - Country:US
Practice Address - Phone:267-895-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139319104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker